Cost-effectiveness of chemotherapy versus targeted therapy in breast cancer: A retrospective analysis in tertiary care hospital

Abstract

Background

Breast cancer represents a significant economic burden globally, with treatment costs varying substantially between conventional chemotherapy and newer targeted therapies. Economic evaluation is essential for healthcare decision-making, particularly in resource-limited settings.

Objective

To evaluate the cost-effectiveness of targeted therapy versus chemotherapy in breast cancer treatment from a healthcare system perspective in an Indian tertiary care hospital setting.

Methods

A retrospective cost-effectiveness analysis was conducted comparing patients receiving chemotherapy versus targeted therapy for breast cancer. Direct medical costs were calculated including drug costs, hospitalization, and diagnostic services. Health outcomes were measured using quality-adjusted life years (QALYs) derived from patient-reported EQ-5D visual analogue scale (VAS) based utility values accrued during treatment and post-treatment progression-free survival. The incremental cost-effectiveness ratio (ICER) was calculated and compared against India's willingness-to-pay threshold based on per capita GDP.

Results

The analysis included two treatment groups: chemotherapy (mean cost: ₹52,173) and targeted therapy (mean cost: ₹1,044,113). QALYs achieved were significantly higher in the targeted therapy group (2.398 vs 1.083, p < 0.001). The ICER for targeted therapy was ₹754,264 per QALY gained, which falls below willingness-to-pay threshold of 2–3 times per capita GDP (₹806,428–₹1,209,642).

Conclusions

Despite substantially higher treatment costs, targeted therapy demonstrates cost-effectiveness compared to chemotherapy when considering health outcomes. The ICER remains within acceptable thresholds for India, supporting targeted therapy as a cost-effective treatment option for appropriate breast cancer patients.